For the past several decades the healthcare industry has been relying on manual paper-based methods for information management. Now we are entering a new era of automatic patient monitoring, smart hospitals and smart homes where services based on cloud computing will deliver next-generation healthcare. With this shift, one of the problems that the healthcare industry is currently facing is of management and sharing of Massive size healthcare data. Exponential growth has been observed in the generation of Electronic Health records. In 2012, worldwide digital healthcare data was estimated to be 500 petaBytes and is expected to reach 25,000 petabytes in 2020. Storage, automated Analysis and management of both structured and unstructured type of data is a challenging task.
Cloud computing has emerged as a new paradigm that can help provide cost-effective and scalable IT services delivered over the internet. National institute of standards and technology have defined cloud computing as
``A model for enabling convenient, on-demand network access to a shared pool of configurable computing resources that can be rapidly provisioned and released with minimal management effort or service providers interaction.”
In this paradigm, cloud service providers are responsible for the management of hardware and software needed to keep the IT systems operational at all times. Hence for healthcare organisations this saves the overhead of having a dedicated in-house IT department to manage healthcare computing infrastructure.
The development of new devices, such as healthcare monitors and sensors that perform continuous patient monitoring are providing new sources of health- care data. Inferring knowledge from these complex heterogeneous sources can lead to new insights and predictions that can improve patient healthcare. However, integrating these data sources together would require the development of new data conversion and exchange mechanisms.
Cloud computing holds the potential of making health information sharing and integration much easier but presents a new set of new challenges such as developing new protocols and platforms that allow interoperability of Healthcare data through standardization of data exchange formats etc. Furthermore, challenges such as privacy, network security and cultural resistance need to be addressed before users and organizations can upload sensitive information to the cloud. For effective and timely decision-making, Physicians require timely access to all of the patients historical medical records. Electronic Medical Records (EMRs) of the patients are usually dispersed and stored locally among different Care delivery Organisations
In healthcare solutions, we are moving towards an era of continuous monitoring, where devices sense the vital signs of humans and monitor critical changes thus delivering better healthcare. Also with the emergence of modern healthcare solutions and competition amongst healthcare organizations the user expectations are ever-increasing. Some of the Characteristics of modern healthcare solutions include context-awareness, remote monitoring, ubiquitous access to data and the ability to interact with the environment. Mobile Cloud Computing can provide some of these services, namely remote monitoring, collaborative consultation, and electronic health record. These services rely on mobile computing combined with cloud computing to make data accessible from any location. This merger is necessary due to the inherent constraints in mobile computing such as re- source scarceness, finite energy and low connectivity. Cloud computing enables us to off-load the majority of the compute load onto the cloud, thus helping us overcome such constraints.
The Healthcare industry has been slow when it comes to the adaptation of solutions built using cloud-based technologies. HealthCare solutions are costly to build and manage. Data Incompatibility issues in the healthcare industry are common because of legacy data formats and sometimes unstructured and heterogeneous nature of medical data. This makes healthcare data management a fairly tedious and complicated task. Moreover, privacy concerns have made Healthcare organization cautious when it comes to adopting these solutions. Healthcare Data records need to be accessible and available to researchers and everyone involved in the delivery of patient healthcare. Current EMR systems employed are highly centralised, where every healthcare provider has its own local EMR system This makes healthcare data of patients highly dispersed and its management difficult. In an ever-connected world, timely retrieval of all the dispersed healthcare data for effective diagnosis and analysis still remains a challenge.
Medical Research organisations that have expertise in big data storage and analytics require that dispersed data from various sources gets combined and stored in one place for effective querying. Lack of standardization of medical data formats, data lock-in, privacy concerns and lack of patient consent and authorisation are the key challenges such research organisations face. There is thus a need of simplified data exchange formats that can make data transmission and storage easier and can overcome the challenges of incompatibility and heterogeneity of data sources.
Efficient Information retrial is key a challenge that any healthcare solution must address. Limited access to patient-related information at critical decision-making moments is a major problem that the healthcare industry currently faces. Modern healthcare solutions need to provide doctors and other healthcare staff with pervasive and ubiquitous real-time access to patient data from any digital devices. For example, in the case of medical emergency physicians need quick access to lab results, as soon as they are available. Cloud Computing can provide effective information retrieval after integration and analysis of data from various sources.
Another key aspect of data management is data reliability. Cloud providers should offer data backup options and disaster recovery options to its users. Policies for safeguarding against data loss should be employed by CSPs. This is necessary to gain the trust of healthcare organisations that are still wary of data reliability issues when it comes to shifting to cloud-based solutions.
Cost is a major issue that healthcare organizations face when implementing- ing a certain IT solution. Ensuring reliability and safety of data while keeping costs down is a major challenge for these organizations. Furthermore, huge amounts of data are being generated every day by the healthcare sector. Cost-effective management of this ever-increasing data is a challenge on it own.
With the emergence of Cloud Computing information and large data sharing amongst organizations has been made much more affordable. Cloud computing offers on-demand and pay per use payment models that help organizations minimize operational costs. A number of diverse service models are offered by cloud computing vendors each having its own pros and cons. Examples of these include Software as a Service (SaaS), Platform as a Service (PaaS) and Infrastructure as a Service (IaaS).
In the past patient data used to reside in hospitals. Moving this data containing sensitive personal details to cloud poses serious threats to the privacy of patients. Thus modern healthcare solutions require high trust mechanisms to enable data and privacy protection. Generally speaking SaaS(Software- as-a-Service) model offers less control over data and infrastructure compared to PaaS(Platform-as-a-Service) or IaaS(Infrastructure) models. The later models require that CSPs and clients collaborate to secure user data and applications. Several standards such as Trusted Platform Module TPM, Self Encrypting device have been employed by Cloud Service Providers. Depending on requirements, the Private cloud is another solution for independent single organisations. The intent here is to provide strong security features while having all the characteristics of a public cloud. Several data storage and retrieval schemes exist to ensure data protection in the cloud. Some folks have argued that cloud service providers should be willing to undergo external audits and security certifications. Furthermore having an active auditing scheme ensures secondary protection against bugs and vulnerabilities.